The American Heart Association and the American College of Cardiology released new guidelines on who should take cholesterol-lowering drugs. Currently about one-quarter of Americans over the age of 40 are taking a drug to lower their cholesterol.

According to The New York Times, the new guidelines were intended to simplify the process of deciding who should be on cholesterol-lowering medications. But experts fear it’s made the decision more complex:

It is not clear whether more or fewer people will end up taking the drugs under the new guidelines, experts said. Many women and African-Americans, who have a higher-than-average risk of stroke, may find themselves candidates for treatment, but others taking statins only to lower LDL cholesterol to target levels may no longer need them.

The previous guidelines put such a strong emphasis on lowering cholesterol levels by specific amounts that patients who did not hit their target levels just by taking statins often were prescribed additional drugs…But the new guidelines say doctors should no longer prescribe those extra medicines because they have never been shown to prevent heart attacks or strokes.

Finally, one expert believes the new guidelines will benefit no one — but drug companies.

This announcement is not a result of a sudden epidemic of heart disease, nor is it based on new data showing the benefits of lower cholesterol. Instead, it is a consequence of simply expanding the definition of who should take the drugs — a decision that will benefit the pharmaceutical industry more than anyone else.

“According to The New York Times, the new guidelines were intended to simplify the process of deciding who should be on cholesterol-lowering medications. But experts fear it’s made the decision more complex”

“But the new guidelines say doctors should no longer prescribe those extra medicines because they have never been shown to prevent heart attacks or strokes.”

This should be prime evidence to the AHA that it isn’t cholesterol that causes heart attacks, but inflammation combined with cholesterol. Yet that would mean admitting they were wrong for so many years.

I find it interesting that in the process of recommending cholesterol drugs, these two organizations are also forgoing actual targets for cholesterol. Considering that Americans already prone to prescription non-adherence, these new guidelines would game this phenomenon worse.

Something else that intrigues me about this decision. The guidelines eliminate the need for periodic blood tests. Merck had tried to get Mevacor (i.e. Lovastatin) approved for over-the-counter sales three times in the past decade and was turned down by the FDA on all three occasions. Part of the reasons member of the FDA advisory committees cited was that people taking OTC statins might adequately self-diagnosis. They may also forgo periodic blood tests for cholesterol and for liver enzymes.